NPI | 1255673604 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 60840) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207R00000X Internal Medicine (Licence: TN 60840) | |
207R00000X Internal Medicine (Licence: MI 4301103028) | |
Enumeration Date | 2013-03-25 |
Last Update Date | 2020-10-15 |